Document Detail

Serial first- and second-trimester Down's syndrome screening tests among IVF-versus naturally-conceived singletons.
MedLine Citation:
PMID:  11925409     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: It has been reported that second-trimester serum markers may be affected by assisted reproduction, leading to a higher false-positive rate. METHODS: A total of 285 naturally and 71 IVF-conceived singletons which underwent a serial disclosure Down's syndrome screening programme were compared. The study protocol included first-trimester combined [nuchal translucency (NT), free beta-HCG and pregnancy-associated plasma protein-A (PAPP-A)] testing. The second-trimester triple serum screening included alpha-fetoprotein (AFP), intact HCG and unconjugated estriol (uE3). After excluding aneuploidies, miscarriages, anatomical anomalies and cases with incomplete follow-up, the serum samples of normal cases were assessed and correlated. RESULTS: NT measurement was not significantly changed in either group. However, the IVF group had lower PAPP-A [0.96 versus 1.05 multiples of normal median (MoM)] and higher AFP (1.13 versus 1.07 median MoM). Both groups had similar rates of first-trimester false-positive results (FPR; 7 and 9% respectively), but the IVF group had a significantly higher mid-gestation FPR rate (10 versus 5%; Pearson chi2, P = 0.029). This has contributed to amniocentesis uptake rates of 15 and 13% for the IVF and natural conception pregnancies respectively. CONCLUSIONS: The IVF group tended to have a significantly higher second-trimester FPR rate. To counterbalance this phenomenon, integrated first- and second-trimester screening tests or the use of NT alone might be a reasonable option that deserves further investigation.
R Maymon; A Shulman
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Human reproduction (Oxford, England)     Volume:  17     ISSN:  0268-1161     ISO Abbreviation:  Hum. Reprod.     Publication Date:  2002 Apr 
Date Detail:
Created Date:  2002-04-01     Completed Date:  2002-10-09     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8701199     Medline TA:  Hum Reprod     Country:  England    
Other Details:
Languages:  eng     Pagination:  1081-5     Citation Subset:  IM    
Department of Obstetrics and Gynecology, Assaf Harofe Medical Center, Zerifin, Israel.
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MeSH Terms
Down Syndrome / diagnosis*,  embryology
False Positive Reactions
Fertilization in Vitro*
Longitudinal Studies
Pregnancy Trimester, First
Pregnancy Trimester, Second
Pregnancy-Associated Plasma Protein-A / analysis*
Prenatal Diagnosis / methods*,  standards
Reference Values
alpha-Fetoproteins / analysis
Reg. No./Substance:
0/alpha-Fetoproteins; EC 3.4.24.-/Pregnancy-Associated Plasma Protein-A

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